Tuesday, July 28, 2015

World Hepatitis Day 2015: Prevent hepatitis. Act now

On World Hepatitis Day, 28 July, the World Health Organisation (WHO) is highlighting the urgent need for countries to enhance action to prevent viral hepatitis infection and to ensure that people who have been infected are diagnosed and offered treatment.

This year, the Organization is focusing particularly on hepatitis B and C, which together causes approximately 80% of all liver cancer deaths and kills close to 1.4 million people every year.

The theme for this year’s World Hepatitis Day is “Prevent hepatitis. Act now”.

In India, it is estimated that prevalence of hepatitis C infection is more than 6 times the prevalence of HIV infection. The World Health Organisation has called the HCV a “viral time bomb”, which signifies that the policy makers must pay the required attention towards this health issue.

WHO is alerting people to the risk of contracting hepatitis from infected blood, infected injections, and sharing drug-injection equipment.

Risk factors, symptoms and causes

Hepatitis A: This form of hepatitis is commonly found in children and is usually spread by fecal-oral contact or fecal-infected food and water.

A baby could get hepatitis A by consuming food/water contaminated with HAV-infected stool.

Parents might not even know that their children have caught the disease as hepatitis A can be a mild infection. However, in serious cases of infection, symptoms include fever, vomiting, fatigue, loss of appetite, abdominal discomfort, dark-colored urine, and jaundice.

Hepatitis A usually causes mild illness, but it can also cause prolonged illness for upto six months

Hepatitis B: The hepatitis B virus is spread by contact with blood and other body fluids of an infected person. Infants may contract hepatitis B if they are born to a mother who has the virus.

In adults, it can be transmitted through unprotected sex with an HBV-infected person and sharing of contaminated needles or syringes for injecting drugs.

Symptoms may range from a mild illness to more serious chronic liver disease that can result in liver failure. Common symptoms may include fever, vomiting, loss of appetite, jaundice, etc.

Hepatitis C: It is more common in adults than in children. Hepatitis C is transmitted through direct contact with human blood and other body fluids. A baby can also get hepatitis C from his/her infected mother.

In adults, it can also be acquired through sexual contact with an infected person or through intravenous drug use.

Symptoms are usually mild and children often show no symptoms at all and therefore, parents get to know about their kid's disease at a later stage.

Hepatitis C leads to chronic liver disease in a majority of people infected with the virus. HCV is also considered to be the leading cause for liver transplantation in adults. Chronic hepatitis C virus infection is also linked with cancer.

Tests and diagnosis

All of the above conditions can be diagnosed through blood tests. A healthcare provider may also ask for liver function tests in order to determine the extent of the damage. A liver biopsy may be asked to do to further check for organ damage. Other tests and diagnostic procedures to determine the extent of the disease include CT scans and MRI.

Prevention

Like any other diseases, practising a good hygiene can help prevent the risk of getting as well as spreading hepatitis. Other preventive measures include:

Vaccinations - vaccinations are available for HAV and HBV, unfortunately, there's no vaccine for HCV.

WHO recommends vaccinating all children against hepatitis B infection. The vaccine should be given as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by 2 or 3 doses to complete the vaccine series. A safe and effective vaccine can protect from hepatitis B infection for life.

WHO also recommends vaccinating adults who are at increased risk of acquiring hepatitis B.

Blood transfusion – to reduce the risk of infection, blood transfusion is routinely screened for hepatitis B and C.

Monday, July 27, 2015

Tobacco smoking and chewing raises the risk of Leukoplakia and Oral cancer

With leukoplakia, thickened, white patches form on our gums, the insides of our cheeks, the bottom of our mouth and, sometimes, our tongue. These patches can't be scraped off.
Tobacco — whether smoked, dipped or chewed — is considered to be the main culprit in its development. Tobacco use puts you at high risk of leukoplakia and oral cancer. Drinking alcohol combined with smoking further increases your risk.
Leukoplakia usually isn't dangerous, but it can sometimes be serious. Although most leukoplakia patches are noncancerous (benign), some show early signs of cancer. Many cancers on the floor of the mouth — beneath the tongue — occur next to areas of leukoplakia. For that reason, it's best to see a good doctor if you have unusual, persistent changes in your mouth. Oral cancer is a potentially serious complication of leukoplakia. Oral cancers often form near leukoplakia patches, and the patches themselves may show cancerous changes. Even after leukoplakia patches are removed, the risk of oral cancer remains.
 
When to see a doctor
Sometimes mouth sores can be annoying or painful without being harmful. But in other cases, mouth problems can indicate a more serious condition.
See a good doctor if you have any of the following:
  • White plaques or sores in your mouth that don't heal on their own within two weeks
  • Lumps or white, red or dark patches in your mouth
  • Persistent changes in the tissues of your mouth

Saturday, July 25, 2015

Some home remedies to treat stomach ache

A tummy ache is a common complaint and affects people of all ages. The causes could be several — indigestion, menstrual cramps, irritable bowel syndrome or even gastritis. Simple home remedies might not cure us of our ailment but will definitely ease our symptoms and give us temporary relief. Here's what can help...

- When tummy aches during period, try sipping on a cup of hot chamomile tea. It will ease the cramps and lessen the spasms. Even a regular stomach ache can also be treated with chamomile tea. Its anti-inflammatory properties will relax the muscles of upper digestive track so that the contractions that thrust food in our system, will ease up and reduce cramps and soothe your stomach.

- A hot compress is also an effective way to treat a stomachache. Use a hot water bag or an electric heat pad that will relax abdominal muscles and ease the discomfort.

- An old remedy but an effective one, drinking a cup of rice water will also help ease tummy aches. Instead of throwing away the water that is left after the rice is cooked, add some to a cup and sip on it. It is said to soothe inflammation and provide relief.

- A cup of warm peppermint tea is also said to work wonders when it comes to treating stomachaches. It ensures that your digestive tract works properly by making digestion an easy process.

- Add a few drops of lemon juice in a glass of hot water and drink it. This will help improve the production of hydrochloric acid, known to break down the food you consume and ensures easy digestion.

- Ginger tea is another good option. Simply add some ginger bits to a cup of hot tea and drink it. The chemicals present in ginger relax the stomach muscles and relieve cramps. You could also add ginger bits to honey and warm water and drink it.

Thursday, July 23, 2015

India needs to strengthen its effort to tackle spread of Hepatitis B: WHO report

Hepatitis B poses a major threat to Indians. World Health Organization (WHO) estimates that approximately 40-60 million people in India are carriers of the Hepatitis B virus and the virus may affect two to five percent of India's population. Each year, 100,000 patients die of viral Hepatitis (including Hepatitis B and C).

A WHO report, which analyzed country-level performance in tackling the virus points out that the Union government is not doing enough to curb the spread of the disease.

The WHO report has severely criticized India's approach to tackling Hepatitis B, after conducting a global survey of nations and their policies on awareness-raising and partnerships, steps to prevent transmission, as well as taking adequate care for screening and treatment.

This means that we in India do not know for sure, as to how many persons are infected with Hepatitis or are dying because of it. Rough estimates are drawn by WHO at a regional level, but the Union Health Ministry in India has no specific data to compare.

A large number of general practitioners diagnose jaundice, which is the initial symptom of Hepatitis A, E (non-infectious) and B, C (infectious), but do not recommend specialized blood tests.

They treat jaundice based on suspicion with basic medications, but may not test the blood for viral or non-viral Hepatitis. These cases are missed. The government has not made it mandatory for Hepatitis to be reported. How can it maintain data then?

Thus every patient who acquires jaundice is a high risk patient of viral Hepatitis (B or C) and to eliminate any long-term risk to health, like near-lethal deterioration of the liver, must mandatorily get the screening tests done for viral Hepatitis.

The WHO report also notes that there are not enough laboratories in the country to diagnose viral Hepatitis. The Indian labs are equipped with antibody tests to screen blood for Hepatitis virus. But the precision of these tests is merely 80%. Twenty percent of the time, the virus may get missed. Blood transfusions to patients under such risky circumstances are a reality. Also, Hepatitis virus of the B and C type may not get picked up during the window period of 4-6 weeks after a person is infected.

The high quality NAT testing mechanism for blood rarely found in pathology laboratories around the country. Testing the blood through NAT will increase the cost per transfusion by Rs1000. It is still a long road. With NAT though, one can be 100% sure that the blood is free of any virus including Hepatitis. One must always insist on getting the blood tested by NAT mechanism before it is being transfused to patients who are our friends or relatives.

India has not definitively established a goal to eliminate Hepatitis B. The WHO report points out that that there is no national public health research agenda for viral Hepatitis, neither is any routine screening done amongst the general population.

The government should step up its act and intervene by framing policies to tackle Hepatitis B and C. Every patient who comes to a public hospital should be screened for Hepatitis and treatment should be made available for free. Also, screening of all high-risk groups like sex workers and drug users should be made mandatory. Vaccination against the disease amongst adults should be promoted. Any adult can and should get vaccinated against the virus to be on the safer side.

Ayurvedic medicine for making the liver strong and healthy

Ayurveda means the complete knowledge for long life.  Ayurvedic medicine is a system of traditional medicine native to India and practiced in other parts of the world as a form of alternative medicine. In Sanskrit, the word ayurveda consists of the words āyus, meaning "longevity", and veda, meaning "related to knowledge" or "science". Evolving throughout its history, Ayurveda remains an influential system of medicine in South Asia especially India. The earliest literature on Indian medical practice appeared during the Vedic period in India. The Suśruta Saṃhitā and the Charaka Saṃhitā were influential works on traditional medicine during this era. Over the following centuries, ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments .

In Western medicine, ayurveda is classified as a system of complementary and alternative medicine (CAM) that is used to complement, rather than replace, the treatment regimen and relationship that exists between a patient and their existing physician.
There are many Ayurvedic medicines and Ayurvedic companies in India. In fact there are many treatment under Ayurveda for which there is no treatment in western medicine.  Many of the Ayurvedic medicines are common knowledge in Indian household for e.g. the use of Tulsi or Holy Basil leaves. Tulsi’s extracts are used in ayurvedic remedies for common colds, headaches, stomach disorders, inflammation, heart disease, various forms of poisoning, and malaria. 

One such medicine is Kamalahar from Khatore Pharmaceuticals Private limited. It is completely herbal product. The ingredients in Kamalahar which play a key role in the treatment are Tecoma undulata, Phyllanthus urinaria, Embelia ribes, Taraxacum officinale, Nyctanthes arbortritis and Terminalia arjuna.  These ingredients are known to be good for liver. But it is the combination of these natural herbs which the company has pioneered that makes it very effective for liver disorders such as Jaundice, Hepatitis, Cirrhosis and also for liver detoxification. Kamalahar is proven to be very effective in the treatment of Jaundice, Hepatitis and Cirrhosis. Currently many of the patients who suffer from Jaundice or Hepatitis are asked to just rest and control the diet and it can take a very long time before the patients can become normal or sometimes they don’t even become normal. With Kamalahar, it is proven that the patients see result within 1 week and most of them are back to normal in 2 weeks. The product has already benefited millions of patients in the eastern parts of India where the company is based and where its traditionally focused right now. Kamalahar is also taken for liver detoxification to make the liver stronger.  The big stress of current work life takes a heavy toll on our body. The irregular and oil reach diet makes our liver weak and sometimes leads to many other problems . 1 full course of Kamalahar is very useful to detoxify the liver.

Friday, July 17, 2015

Weight-loss surgery may cause liver failure

Weight-loss surgery is often sold as a magic pill for problems ranging from morbid obesity to diabetes. But few surgeons will warn you of severe side effects it may cause if precaution is not taken to assess the condition of the liver prior to the surgery. 

Institute of Liver and Biliary Sciences (ILBS), a state-run hospital for gastrointestinal illnesses in Delhi, has received at least three patients over the past one-and-a-half years with liver failure caused due to weight-loss surgery. 

The patient generally come to hospital with severe jaundice, abdominal pain and extreme weakness. Some of them may require to undergo a liver transplant for long-term survival.

Doctors say any surgery in a cirrhotic patient (whose liver is damaged due to long-term scarring) is risky. In case of weight-loss surgery, which involves reducing the size of the stomach, the bacteria or toxins excessively go into liver and cause further injury leading to failure.

According to some of the experts, liver failure in case of a patient who has undergone weight-loss surgery is as bad as an alcoholic's. The liver is so damaged that living donor transplant is not possible. Only a full-sized liver harvested from cadaver donor can match the graft size required.

The doctors suggest that any patient going for a weight-loss surgery must consider complete assessment of liver condition. Liver function test (LFT), may not give the real picture. Doctors should ideally use a fibroscan with extra lobe or MR spectroscopy to rule out cirrhotic liver.

If the liver is found to be cirrhotic, then surgery should be considered carefully and with respect to the health risks involved. Also, such patients should not starve themselves to lose weight rapidly. 

In India, an estimated 200 million people suffer from weight-related issues. According to Obesity Surgery Society of India, close to 2,000 persons undergo weight-loss surgery every year. Bariatric surgery involves stapling a portion of the stomach to reduce a person's appetite. 

Thursday, July 16, 2015

Non Alcoholic Fatty Liver cases swell in Mumbai and other urban areas

Doctors have found that the incidence of liver failure is on a rise among patients suffering from Fatty Liver Disease (FLD) as opposed to patients with Hepatitis B and C, which is another grave medical concern.

Fatty liver is increasingly becoming the reason behind liver failure disease. This is especially true in urban cities such as Mumbai. Liver is the most important part of the human body which helps with protein production, blood clotting, cholesterol maintaining and other important things. In patients who visit hospitals for evaluation of liver transplant, a large percentage had a fatty liver disease.

It is shocking to note that while many believe that a fatty liver is related to alcohol consumption, 60% of cases are that of non-alcoholics. Further, alcohol has always been considered the root cause of a damaged liver, but even teetotallers who are overweight, with high abdominal obesity or waist circumference have been complaining of liver diseases.

Experts say that the reasons behind non-alcoholic fatty liver can be many. Take for instance obesity, excessive junk food diet, lack of exercise, diabetes and high cholesterol among other lifestyle conditions.

The kind of lifestyle people live these days is increasingly leading to them suffering from fatty liver disease. And this is only going to increase if not controlled.

The health experts have further claimed that the incidence of liver diseases in non-alcoholics can turn into an epidemic in the years to come, if their improper lifestyle is not corrected soon. Further, a rapid increase in the number of liver cancer patients is already being seen in urban cities, mostly due to lifestyle-related problems.

Obesity is more dangerous than alcohol. Globalisation has led to a rise in Non-Alcoholic Fatty Liver Disease (NAFLD). Since obesity and diabetes are correlated with fatty liver, there is an upward trend to the latter. NAFLD is mainly increasing due to wrong dietary habits and high intake of fats, carbohydrates and less consumption of proteins.